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Abstract(s)
O quadro motor de hemiparésia, consequente à paralisia cerebral (PC), corresponde a cerca de 1/3 dos quadros de PC, sendo uma das implicações mais frequentes a alteração do controlo postural, essencial na preparação e ao longo de todo o movimento.
Analisar o controlo postural em crianças com quadro motor de hemiparésia, face à aplicação de um plano de intervenção em Fisioterapia de 12 semanas baseado no Conceito Bobath, complementado por um programa de atividades bimanuais home-based. Participaram neste estudo 4 crianças com quadro motor de hemiparésia, que foram sujeitas a dois momentos de avaliação, antes e após a aplicação do plano de intervenção. Em ambos os momentos, com recurso à Plataforma de Pressões e ao software de avaliação Kinovea®, foram analisadas variáveis cinemáticas referentes à orientação da cervical e do tronco e ainda o comportamento da distribuição de carga durante a realização de três tarefas: “início da marcha”, “agarrar a caixa” e “sentado para de pé”. Foram ainda aplicados o Teste de Medida das Funções Motoras e os testes funcionais “Sentar e levantar da cadeira” e o “Timed-Up and Go”.
Após o período de intervenção, verificou-se uma orientação mais adequada da omoplata contralesional, bem como dos hemitroncos, associado à redução das estratégias compensatórias adotadas pelas crianças. Verificou-se ainda uma distribuição de
carga na base de suporte mais simétrica, bem como uma modificação do comportamento, da atividade e da função do membro superior contralesional. Os resultados obtidos permitem concluir que o plano de intervenção foi capaz de modificar a orientação do tronco, associado à redução das estratégias compensatórias e ainda o comportamento da distribuição de carga na base de suporte, associado a uma distribuição mais simétrica, sugerindo uma maior estabilidade de tronco inferior e pélvis.
Introduction: Children with hemiplegic cerebral palsy constitute approximately 1/3 of every child with cerebral palsy. One of the many implications is the postural control impairment, essential before and during every movement. Aim: To assess postural control in children with hemiplegic cerebral palsy after a twelve-week Physiotherapy intervention program, based on the Bobath Concept and supplemented by a home-based bimanual activities program. Methods: Two evaluation moments were considered, before and after the application of the intervention program. In both moments, a pressure platform and the Kinovea software were used in order to analyse kinematic parameters regarding both cervical and trunk orientation and the behaviour of pressure distribution while performing three functional activities (gait initiation, reach-to-grasp a box, sitto- stand) in four children of the present case reports’ sample. Additionally, the Gross Motor Function Measure, the Sit to Stand 30’ and the Timed Up and Go were applied to the children in question. Results: At the end of the twelve-week intervention program, a more suitable scapular and hemitrunks’ orientation was verified, consistent with a decrease of compensatory strategies. In addition, a more symmetric load distribution was verified, as well as a modification of behaviour, activity and function of the contralesional upper limb. Conclusion: The obtained results suggest that a twelve week Physiotherapy intervention program based on the Bobath Concept and supplemented by a home-based bimanual activities program was able to modify trunk’s orientation with reduced compensatory strategies associated, as well as load distribution with more symmetry associated, suggesting better pelvis and inferior trunk’s stability.
Introduction: Children with hemiplegic cerebral palsy constitute approximately 1/3 of every child with cerebral palsy. One of the many implications is the postural control impairment, essential before and during every movement. Aim: To assess postural control in children with hemiplegic cerebral palsy after a twelve-week Physiotherapy intervention program, based on the Bobath Concept and supplemented by a home-based bimanual activities program. Methods: Two evaluation moments were considered, before and after the application of the intervention program. In both moments, a pressure platform and the Kinovea software were used in order to analyse kinematic parameters regarding both cervical and trunk orientation and the behaviour of pressure distribution while performing three functional activities (gait initiation, reach-to-grasp a box, sitto- stand) in four children of the present case reports’ sample. Additionally, the Gross Motor Function Measure, the Sit to Stand 30’ and the Timed Up and Go were applied to the children in question. Results: At the end of the twelve-week intervention program, a more suitable scapular and hemitrunks’ orientation was verified, consistent with a decrease of compensatory strategies. In addition, a more symmetric load distribution was verified, as well as a modification of behaviour, activity and function of the contralesional upper limb. Conclusion: The obtained results suggest that a twelve week Physiotherapy intervention program based on the Bobath Concept and supplemented by a home-based bimanual activities program was able to modify trunk’s orientation with reduced compensatory strategies associated, as well as load distribution with more symmetry associated, suggesting better pelvis and inferior trunk’s stability.
Description
Keywords
Paralisia cerebral Conceito Bobath Atividades bimanuais Programas home-based Controlo postural Postural control Cerebral palsy Homebased programs Bobath Concept Bimanual activities